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Noem’s IHS Reform Bill Receives Ways and Means Committee Approval

WASHINGTON, DC – With recruitment of quality medical staff being one of the top challenges within Indian Health Service (IHS) facilities in South Dakota, the House Ways and Means Committee today unanimously approved provisions introduced by Rep. Noem to offer tax-free student loan repayment for IHS medical staff. The provisions are part of Noem’s HEALTTH Act, which aims to fundamentally reform the IHS. Because of the comprehensive nature of Noem’s HEALTTH Act, the legislation must next receive approval from the House Natural Resources and Energy & Commerce committees.

“The kind of care being delivered by the IHS puts lives in jeopardy,” said Noem.
“One of the many hurdles we face is the recruitment of competent medical staff. The HEALTTH Act provision approved today offers a new, more competitive, incentive to help recruit the kind of workforce needed to improve the quality of care. I thank Chairman Brady and the committee for making this step forward.”

“A healthcare system is only as good as the staff that supports it,” said Ways and Means Chairman Kevin Brady. “I appreciate Rep. Noem’s effort to recruit more clinicians to deliver care in tribal communities, and thank her for bringing a targeted solution to the Ways and Means Committee that will help enhance efficiency, staff recruitment resources, and accountability for the communities IHS serves.”

Currently, IHS medical staff may participate in a student loan repayment program; however, participants must pay taxes on the repayment amounts, reducing the program’s benefit. Under the provision approved by Ways and Means today, the student loan repayments would be offered tax free, increasing the value of this incentive. If enacted, IHS would be on a level playing field with programs like the National Health Service Corps, which provides care to underserved areas and already receives student loan repayment tax free.

WATCH as Rep. Noem discusses the legislation at today’s committee hearing. Additionally, Rep. Danny Davis (D-IL) explains his support for the legislation.

In addition to the provisions reviewed by the Ways and Means Committee today, Noem’s HEALTTH Act:

+ Gives tribes a seat at the table to encourage better, longer-term contracts by allowing for a partnership among IHS, tribal communities and healthcare stakeholders to collaborate throughout the contract negotiating process, rather than leaving those decisions solely to IHS.

+ Addresses the current recruitment problem – for both medical staff and hospital leadership – by putting provisions in place to:
· Allow for faster hiring.
· Make the existing student loan repayment program tax free, as an added incentive for high-quality employees.
· Provide incentives to attract competent and well-trained hospital administrators as well as medical staff.

+ Reforms the Purchased/Referred Care (PRC) Program by, among other things:
· Requiring IHS to develop a new formula for allocating PRC dollars. Under Noem’s bill, IHS would be required to develop a formula based on need, population size, and health status to ensure those areas that have the greatest need receive a greater portion of the funding.
· Requiring IHS to negotiate Medicare-like rates for services it pays for with private providers. IHS currently pays a premium for PRC services. Noem’s proposal would bring payments in line with what Medicare pays to stretch every dollar further.
· Requiring IHS to address the backlog of PRC payments to private providers. Private hospitals in the Great Plains Area have long expressed concern because IHS has failed to pay their bills. Noem would require IHS to put a strategy in place to get these hospitals paid what they are due.

+ Restores accountability through strategies, such as:
· Require IHS to be accountable for providing timely care.
· Require the Government Accountability Office to report on the financial stability of IHS hospitals that are threatened with sanction from the Centers for Medicare and Medicaid Services.

The legislation has been endorsed by the Rosebud Sioux Tribe, the National Indian Health Board, Avera, Rapid City Regional Health, Sanford Health, the South Dakota Association of Healthcare Organizations, the South Dakota State Medical Association, the South Dakota Dental Association and others.